Provider Demographics
NPI:1336762020
Name:ADAMS, JEREMIAH THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JEREMIAH
Middle Name:THOMAS
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 PLANTATION RD SW
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-3046
Mailing Address - Country:US
Mailing Address - Phone:404-913-3053
Mailing Address - Fax:
Practice Address - Street 1:255 PLANTATION RD SW
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-3046
Practice Address - Country:US
Practice Address - Phone:404-913-3053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor